How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $575.44 Median $6,760.83 Typical High $11,481.54 | Facility | None | $575.44 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | None | $575.44 | $575.44 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,513.56 | Professional | None | $501.19 | $616.60 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,174.90 | $1,584.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,897.79 Typical High $13,182.57 | Facility | None | $2,754.23 | $4,897.79 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,737.80 | Professional | None | $660.69 | $776.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,659.59 | Professional | None | $457.09 | $630.96 | $1,659.59 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $478.63 |
Where New Jersey sits
The same service costs 7.4 times more in Oklahoma than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Jersey· 48th of 51
$776
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.